Shigella Watch

The Winnebago County Health Department is reporting additional cases of Shigellosis in our community, bringing the new total to 152, since October 2015. The majority of these cases are isolated and have impacted in children in daycare and elementary schools.

Todd Kisner with the Department’s Center for Health Protection says the best way to prevent the disease, which can cause diarrhea and vomiting, is to enforce routine handwashing, particularly among children.

“When it comes to children, supervision of handwashing may be more appropriate now because not all kids are perfect handwashers yet,” he says.

While an increase in cases is likely over the next few weeks, Kisner says it’s due to doctors performing more routine testing. However, he addds that Kisner says with effective hygiene practices, lingering shigella bacteria won’t live long enough to spread further.

According to a Public Health Warning, on Saturday afternoon, October 17, 2015, the Santa Clara County Public Health Department was notified by a local hospital of 5 patients with fever and diarrhea who had all eaten at the same restaurant. Subsequent case finding has revealed a total of over two dozen individuals with fever and diarrhea who ate at Mariscos San Juan restaurant (205 N. 4 Street) in downtown San Jose on Friday October 16 or Saturday October 17. The restaurant was closed on Sunday morning and remains closed.

Of the ill persons, over a dozen have tested positive for Shigella by PCR, and one has a blood culture growing Shigella sonnei; almost all of the reported cases have required hospital admission, and 11 are in intensive care. There are other individuals who were seen and not admitted or who were ill but did not seek medical attention.

Shigella infection can be subclinical, but typically causes watery or bloody diarrhea with abdominal pain, fever, tenesmus, and malaise. Shigella is very infectious with just 10 -100 organisms are sufficient to cause disease. Transmission occurs via the fecal – oral route and can be spread by eating food prepared by an infected food handler or by direct person – to – person contact. Sexual transmission may also occur. Young children, the elderly, and HIV – infected individuals with CD4 count < 200 are more likely to have severe symptoms including dehydration, bacteremia, and seizures.

The Kansas City Health Department put out new numbers on Friday, explaining that the city normally sees 10 cases of Shigella a year. So far in 2015, there have already been 150 reported cases. From January 1 to July 1 this year, there were 16 reported cases. In the past two months, 134 additional cases. That total, 150, is 15-times the annual average.

Shigella is an infectious bacterial illness that causes high-spiking fever, upward of 104 to 105 degrees Fahrenheit. Doctors say Shigella can also cause seizures. Though adults are also susceptible, the majority of the patients are children. Many cases have been reported in daycares and elementary schools.

Doctors say symptoms include diarrhea, abdominal cramping, nausea, vomiting, and fever. They say antibiotic treatment will help, though it requires culture testing to determine which kind of medicine is needed.

Shigella that causes diarrhea in children is on the rise in Cincinnati, Ohio, prompting a warning from city health officials.

Shigella is spread through contaminated food and water; people can also spread it if they don’t wash their hands after handling a diaper or using the bathroom.

There were 20 cases reported in July and August, compared to just one over the same period last year. Northern Kentucky is also seeing an uptick.

Although diarrhea is the most common symptom, Shigella can also cause vomiting, fever, nausea and bloody stool. Symptoms of Shigellosis, the infection caused by the Shigella bacteria, usually go away in five to seven days.

In 2013, the state of Indiana reported approximately 100 cases of the gastrointestinal bacterial infection, shigellosis. This year, state health officials say that number is more than 1,000.

Every year, about 14,000 cases of shigellosis are reported in the United States, according to the Centers for Disease Control and Prevention (CDC).

“Shigellosis has a cyclical trend, so we would expect to see an overall increase in cases some years,” said State Health Commissioner Jerome Adams, M.D., M.P.H. “This year, we have seen a strong association with younger children, which has helped drive the outbreak and significantly increased the number of cases.”

According to the Indiana State Department of Health, shigellosis is spread from person-to-person through the fecal-oral route. The bacteria can be transferred easily among children because of their poor hand washing habits and tendency to put things in their mouths. People can also become infected by consuming food or drinks prepared by an infected person or handling or cleaning up feces.

Symptoms usually begin 24 to 72 hours after exposure and last about four to seven days without treatment; however, severe infections may require antibiotics.

Nancy Luna reports that Zov’s restaurant in Irvine was forced to shut down briefly Wednesday in the wake of a foodborne illness probe tied to four sick customers, health department officials said Thursday.

The sickened guests ate at Zov’s on Portola on three different dates between Sept. 16-22, said Deanne Thompson, a spokeswoman for the county’s Health Care Agency. All four people tested positive for shigella, an intestinal disease that triggers severe diarrhea.

Health investigators cleared Zov’s to reopen the same day after the restaurant’s owners took quick action to sanitize the restaurant and discard all ready-to-eat foods including fresh produce.

Employees, who cannot return to work until they are medically cleared by the health agency, were also given training on proper hand-washing, Thompson said.

With over 200 cases of shigellosis reported in the state and many parents in Indiana are keeping children out of the water where it’s believed many are contracting the illness.

In Michigan this summer Kalamazoo County has been the heart of the same nasty bacterial intestinal disease, and the numbers continue to grow.

“It’s all over the board. We’re at 42 confirmed or probable cases,” said Mike Phillips, disease surveillance nurse, Kalamazoo Community Health and Community Services.

An acute bacterial disease involving the intestinal tract, with symptoms often including bloody diarrhea, shigella “is really rough on an old person or a young person,” Phillips said.

Shigella bacteria are passed, when a person comes in contact with the fecal matter of an infected person. This contact can come from the hands or clothing of an infected person up to a week after the person no longer shows signs of the condition. As hand washing, and careful cleanup are methods of preventing the spread of the condition, it often affects young children who still might have trouble with basic hygiene. It is often seen in toddlers who are not fully toilet trained and can pass along to other members of the child’s family.

According to the Arkansas State Health Department dozens of employees at Walmart home office in Bentonville are overcoming an outbreak of Shigellosis. The Salsarita’s Restaurant at the Walmart Home Office Cafe is closed while the Arkansas Health Department works to figure out how people got sick with Shigella, a food-borne illness that causes stomach trouble. The health department conducted an inspection last Wednesday right after people started getting sick.

Inspectors found nine violations on that inspection. Of those nine violations, five were marked priority, meaning they were concerns that needed to be fixed fast.

Some violations included, employees not washing their hands or touching cooked food without wearing gloves.

The report said raw chicken had been dripping on bottled drinks.

A second inspection was done Monday. Inspectors found seven violations, some of them are the same.

The health department has planned a second follow-up inspection for next week.

The health department said they will be doing a follow-up inspection at the Walmart home office within the next few days.

The department also said it has confirmed 19 cases of Shigella and 139 probable cases.

Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Shigella outbreaks. The Shigella lawyers of Marler Clark have represented thousands of victims of Shigella and other foodborne illness outbreaks and have recovered over $600 million for clients. Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation. Our Shigella lawyers have litigated Shigella cases stemming from outbreaks traced to a variety of sources, such as tomatoes, airplane and restaurant food.

According to the Arkansas State Health Department dozens of employees at Walmart home office in Bentonville are overcoming an outbreak of Shigellosis.

KHBS reports the Salsarita’s Restaurant at the Walmart Home Office Cafe is closed while the Arkansas Health Department works to figure out how people got sick with Shigella, a food-borne illness that causes stomach trouble. The health department conducted an inspection last Wednesday right after people started getting sick.

Inspectors found nine violations on that inspection.

Of those nine violations, five were marked priority, meaning they were concerns that needed to be fixed fast.

Some violations included, employees not washing their hands or touching cooked food without wearing gloves.

The report said raw chicken had been dripping on bottled drinks.

A second inspection was done Monday. Inspectors found seven violations, some of them are the same.

The health department has planned a second follow-up inspection for next week.

Walmart Spokesperson Brooke Buchanan released the following statement Thursday.

“Walmart is committed to protecting the health and safety of our associates. We recently became aware that several people fell ill after eating at Salsarita’s in the Home Office cafeteria, which is operated by Eurest. While the source of the reported illnesses has not been confirmed, out of an abundance of caution, Eurest has voluntarily suspended operations of the Mexican food bar. The Walmart Food Safety team is working in full cooperation with the Benton County Health Department and Eurest to determine the exact cause.”

Miami-Dade County health officials are asking parents to take precautionary measures to prevent the spreading of shigellosis, an infectious disease often reported in children ages 1 through 9.

The disease is caused by a group of bacteria called Shigella and is extremely contagious, the Florida Department of Health said in a statement Tuesday. It can spread from person to person and symptoms include diarrhea that is watery and sometimes bloody, nausea, vomiting, abdominal pain and fever.

In extreme cases, especially with children and seniors, the disease can lead to hospitalization due to dehydration, said Gigi Rico, an epidemiologist with the Florida Department of Health in Miami-Dade. She added that the disease is mainly spreading within the household with siblings passing it on to each other and then infecting their parents.

“The young ones are probably the ones who allow it to continue,” Rico said, adding that the disease was probably introduced into the community due to a lack of hand washing.

The county has seen an increase in cases the past three months, officials said, with more than 100 confirmed cases reported since January 1. That is as much as the yearly average each year for the past three years.

Symptoms first appear within one to three days after contracting the disease, but usually resolve within five days to a week, officials said.

Marler Clark

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About this blog

The Shigella blog supplements Marler Clark’s Web site About Shigella, a site that provides information about Shigella, the symptoms and risks of infection, testing and detection of Shigellosis, and how to prevent the spread of the Shigella bacterium.